This Parent Attestation
Form is a
"one-time promise" that you
the parent or guardian will confirm to enter accurate and timely data related
to your son(s) for the Success Academy
(MOT Program).

all fields
required

I, hereby
attest that the information I will enter related to my son(s) here
named

1

2

Enter Participant Name(s)

3

4

for
the North Metro Success Academy, Career Academy and Men of Tomorrow
Mentoring Sessions are accurate and complete to the best of my
knowledge. I also commit that I will enter the information in a
timely manner as requested by the 100 Black of North Metro and their
agents.

Complete the
fields below to indicate that you have read, understand and confirm
your agreement to the above statements.